What adjunctive therapies to you recommend for symptom control in acute opioid withdrawal beyond full/partial opioid agonists?
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Which adjunctive non-opioid medications have you prescribed to treat opioid withdrawal symptoms?
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2 Answers
Mednet MemberInvited Expert
Hospital Medicine · Oregon Health Sciences University (OHSU)
Answered on
Here are some general recommendations below. I recommend asking the patient what symptoms are most bothersome or what they anticipate to be the most bothersome when prescribing adjuncts. I routinely recommend APAP/ibuprofen, and then usually prescribe something for anxiety and nausea. Tizanidine can also be helpful with muscle spasms/aches/agitation that can occur with fentanyl withdrawal.
| Adjunctive Medication | Dose | Indication |
| Acetaminophen | 500 mg every 6 hours as needed | Mild to moderate pain |
| Clonidine | 0.1 mg three times daily as needed | Sweating, anxiety, restlessness, insomnia |
| Gabapentin | 300 mg every 8 hours as needed | Anxiety, restlessness, insomnia |
| Hydroxyzine | 25 mg every 6 hours as needed | Anxiety |
| Ibuprofen | 40... |
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Mednet MemberInvited Expert
General Internal Medicine · UPMC
Answered on
Full agonists like oxycodone/hydromorphone, non-opioids like clonidine, guanfacine, tizanidine, and anti-emetics.
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